Individual provider Active NPI

Merlyn Mary Thomson

  • Pediatric Nurse Practitioner
  • Texas, TX
National Provider Identifier
1316549157
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1012430 Issued in TX
Practice address
5200 Harry Hines Blvd
Dallas
Texas, TX 75235
Phone
(469) 419-4900
NPI assigned
Nov 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1012430 TX Primary

Addresses

Primary practice location

5200 Harry Hines Blvd
Dallas
Texas, TX 75235

Mailing address

1924 Cochran Dr
Mesquite, TX 75149-5496
Phone (214) 682-0854

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL parklandsecure Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201211000759 TX Practitioner - Nurse Practitioner 1254743438 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1012430TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Pediatrics Current Accepting new patients
Dallas County Hospital District CurrentSince Oct 28, 2020 Accepting new patients
Dallas County Hospital District Pediatrics CurrentSince Oct 28, 2020 Accepting new patients

Locations

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Interoperability endpoints

  • Direct secure messaging: mthomson36714@direct.phhs.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1316549157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 COCHRAN DR",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751495496",
            "telephone_number": "214-682-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "address_2": "DALLAS",
            "city": "TEXAS",
            "state": "TX",
            "postal_code": "75235",
            "telephone_number": "469-419-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "MERLYN",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1012430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "parklandsecure",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5200 Harry Hines Blvd",
            "address_2": "Dallas",
            "city": "Texas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Texas, TX

Sources for this page

Verify at the official NPI Registry.